Take the L.

On social equality grounds, yes.

Of course, that doesn't mean I support M4A.

I've lived outside the US for almost a decade now and am planning to return soon. The two biggest hurdles to navigate/get used to upon return are the ****ty healthcare and gun violence. The latter, for me, can be ignored because I genuinely think the only solution is a complete prohibition and that solution is so far from a reality that it's not worth my time to worry.

Health insurance, however, is ****ing garbage. If I got sick or injured it's just a non issue living outside the states. I don't have to worry about policy changes, the political winds, what "the majority of middle-class voters" support, or the changing winds of policy. Healthcare is just assumed. Having to worry about coinsurance and deductibles and PCMs with HMO networks is something I can do. I'm equipped to figure it out. But to expect the average person to do so is unrealistic. The running assumption, it seems, is "corporations should be able to make profit" as opposed to "people should have access to free healthcare" which is absolute lunacy. I'm 100% single issue until this garbage gets fixed. If it takes the rest of my life, so be it. American healthcare is the kid who can't read who refuses to learn the goddamn alphabet.

Holy ****, LK rising from the ashes. Hows life, bud?

Got married. Still generally cantankerous but don't say much anymore. You?

Why don’t you support M4A?

Yeah I loved living in the US but no way would I ever consider returning without either a) a super job with top-notch insurance or b) if the country goes to low cost UHC.

I'll take secure health care as I get older and more prone to illness over decent weather all day long.

Probably because he has what he perceives as great coverage and doesn't want to lose it.

Because I think there are easier paths and (more controversially) better paths to achieve UHC.

And yes, I do have great coverage but it’s not why I don’t support M4A (at least as proposed by Sanders)

Care to spell them out for us?

An ACA+ with an actual mandate (or auto-enrollment) + ramped up subsidies should get it done. I'd be okay with paying for this with another payroll tax. This kind of plan has the benefit of being much easier to achieve politically since a lot of it can be done piecemeal and some of it can even be done without additional congressional action.

Basically mend the ACA, don't end it.

That doesn’t solve the problem of insurance companies raping people

That’s the issue.

Unless I read the statement wrong, BCBS of South Carolina made a $262M profit with all it's ACA dead weight last year.

Profit.

FrEe MaRkEt cOmPeTiTioN LoWeRs CosTs haHAA

No, they’re not.

Insurance companies by law have to pay out at least 80% of premiums. Industry averages suggest they pay around 90% (a little lower or higher, depending on market) on average.

Fixing the ACA is going to take up fiscal space that could go to something else. It could be done and is probably the path of least resistance and a lot of other countries have heavily regulated quazi public insurance companies so its possible. It's just more expensive. Fixing the ACA means you can do fewer other things while M4A means you do M4A and have more for other things

Oh, most people who aren't covered by the government are covered by private healthcare? No ****, wow, what a statistic

I believe it was Founding Father Patrick Henry who once famously said, "Give me medical bankruptcy, or give me death!"

Not very meaningful without knowing number of policy holders and premiums collected.

This requirement is subject to pretty easy gaming.

But what about the wait times?

TheHip and effen already hit on it, but this would not get it done. An upgraded ACA could actually work, but only if there are significant cost controls implemented, which of course won't happen. What you are suggesting (mandate + more subsidies) would not do enough to solve the cost problem. You need to take a big chunk of profit out of the system to get the U.S. in line with other countries.

And it's not just insurance companies that make amazing profits! The focus on them is understandable because that's how most people interact with the system, but really it's the whole industry from top to bottom. Drug companies, medical device manufacturers, hospitals, wholesalers, insurance companies, etc... all making outsized profits.

lol

Insurance companies make tiny profits relative to the size of healthcare sector.

If we want to drive costs down, We have to basically institute across the board price/profit caps. (A soft cap on profits would work. Something like 50% marginal rate on gross profits over <insert some large number> and a progressive rate based on cost/year/patient or use some kind of qaly) would remove a lot of the incentives to charge unconscionably high prices and still preserve most of the market incentives to research promising drugs and still let really rich people basically subsidize really expensive experimental therapies.

I looked up BCBS in North Carolina to check Effen's claim of their profits and was only able to find an article about how they did in 2017. They had 3.81 million customers who generated $9.4 billion in revenue and had net profits of ~$222 million. That puts their profit margin right around average for US companies in general.

With those numbers, they made about 60 dollars per customer, tiny relative to the average healthcare spending per capita (~10k).

Do you know where those tiny profits come from?

Denying a legitimate claim for a 20,000,000 procedure.

Sorry you dead now but our shareholders got a nice dividend.